| NPI | 1225350580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA HEATHER MANISCALCO Insurance Coordinator 813-250-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN14898) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |